• Integer Holdings Corporation Reports Third Quarter 2024 Results

    Source: Nasdaq GlobeNewswire / 24 Oct 2024 08:00:01   America/New_York

     

    ~ Continued strong performance with 3Q24 financial results ~
    ~ Raising midpoint of 2024 operating profit and EPS outlook ~

    PLANO, Texas, Oct. 24, 2024 (GLOBE NEWSWIRE) -- Integer Holdings Corporation (NYSE:ITGR) today announced results for the three and nine months ended September 27, 2024.

    Our previously announced sale of the Electrochem business for $50 million in cash remains on track and is expected to close later this month. Except for cash flow measures, prior period amounts have been recast to exclude the Electrochem business, which is a discontinued operation, consistent with GAAP continuing operations presentation. Unless otherwise stated, all results and comparisons set forth in this release are presented on a continuing operations basis.

    Third Quarter 2024 Highlights (compared to Third Quarter 2023, except as noted)

    • Sales increased 9% to $431 million, with organic growth of 4%.
    • GAAP income from continuing operations increased $8 million to $36 million, an increase of 29%. Non-GAAP adjusted net income increased $6 million to $50 million, an increase of 14%.
    • GAAP operating income increased $9 million to $58 million, an increase of 19%. Non-GAAP adjusted operating income increased $11 million to $76 million, an increase of 17%.
    • GAAP diluted EPS from continuing operations increased $0.18 per share to $1.01 per share. Non-GAAP adjusted EPS increased $0.14 per share to $1.43 per share.
    • Adjusted EBITDA increased $15 million to $96 million, an increase of 18%.
    • From the end of 2023, total debt increased $119 million to $1.079 billion and net total debt increased $105 million to $1.055 billion, primarily to finance the acquisition of Pulse Technologies, resulting in a leverage ratio of 3.0 times adjusted EBITDA as of September 27, 2024.

    Third Quarter 2024 YTD Highlights (compared to Third Quarter 2023 YTD, except as noted)

    • Sales increased 10% to $1.267 billion, with organic growth of 6%.
    • GAAP income from continuing operations increased $26 million to $88 million, an increase of 41%. Non-GAAP adjusted net income increased $25 million to $133 million, an increase of 23%.
    • GAAP operating income increased $31 million to $151 million, an increase of 26%. Non-GAAP adjusted operating income increased $40 million to $209 million, an increase of 23%.
    • GAAP diluted EPS from continuing operations increased $0.64 per share to $2.49 per share. Non-GAAP adjusted EPS increased $0.67 per share to $3.87 per share.
    • Adjusted EBITDA increased $48 million to $266 million, an increase of 22%.

    “Third quarter year to date, Integer delivered 10% sales growth and a 23% increase in adjusted operating income versus a year ago,” said Joseph Dziedzic, Integer’s president and CEO. “We expect 2024 sales growth of 10% to 11% with above-market organic sales growth of 7% to 8%. We are raising the midpoint of our full year adjusted operating income outlook by $4 million dollars, to 20% year over year, up from 18% in our previous outlook.”

    Mr. Dziedzic added, “The divestiture of Electrochem will make Integer a pure-play medical technology company and provides additional capital to invest in capabilities and capacity that support our targeted growth markets.”

    Discussion of Product Line Third Quarter 2024 Sales

    • Cardio & Vascular sales increased 13% in the third quarter 2024 compared to the third quarter 2023, driven by new product ramps in electrophysiology and structural heart, and the InNeuroCo and Pulse acquisitions.
    • Cardiac Rhythm Management & Neuromodulation sales increased 3% in the third quarter 2024 compared to the third quarter 2023, driven by strong growth in emerging neuromodulation customers with PMA (pre-market approval) products.
    • Advanced Surgical, Orthopedics & Portable Medical sales increased 12% in the third quarter 2024 compared to the third quarter 2023, primarily driven by fulfillment timing of last-time-buy orders related to the planned multi-year Portable Medical exit announced in 2022.

    2024 Outlook(a)

    • The 2024 Outlook excludes Electrochem. As previously communicated, the prior 2024 outlook included the following estimated amounts for Electrochem:
      • Sales of $36 million.
      • GAAP operating income of $3 million. Non-GAAP adjusted operating income of $4 million.
      • Adjusted EBITDA of $5 million.
      • GAAP net income of $0 million. Non-GAAP adjusted net income of $1 million.
      • GAAP diluted EPS of $0.00. Non-GAAP adjusted EPS of $0.02.
      • $3 million of allocated interest expense as part of discontinued operations.
    • Unless otherwise stated, 2024 Outlook and comparisons are presented on a continuing operations basis.
    • We have raised the midpoint of our full year profit and EPS outlook, compared to the 2024 outlook from July, revised to exclude Electrochem.
    (dollars in millions, except per share amounts)GAAP Non-GAAP(b)
     As Reported Change from Prior Year Adjusted Change from Prior Year
    Sales$1,707 to $1,727 10% to 11% N/A N/A
    Operating income$205 to $213 26% to 30% $280 to $288 18% to 22%
    EBITDAN/A N/A $358 to $368 18% to 21%
    Income from continuing operations$122 to $128 37% to 44% $181 to $188 16% to 21%
    Diluted earnings per share$3.42 to $3.61 30% to 37% $5.24 to $5.43 14% to 18%
    Cash flow from operating activities(c)$195 to $205 8% to 14% N/A N/A

     

    (a)Except as described below, further reconciliations by line item to the closest corresponding GAAP financial measure for adjusted operating income, adjusted EBITDA, adjusted net income and adjusted earnings per Share (“EPS”), included in our “2024 Outlook” above, and adjusted total interest expense, adjusted effective tax rate and leverage ratio in “Supplemental Financial Information” below, are not available without unreasonable efforts on a forward-looking basis due to the high variability, complexity and visibility of the charges excluded from these non-GAAP financial measures.

    (b)Adjusted operating income for 2024 consists of GAAP operating income, excluding items such as amortization of intangible assets, restructuring and restructuring-related charges, and acquisition and integration costs, totaling approximately $75 million, pre-tax.

    Adjusted net income for 2024 consists of GAAP income from continuing operations, excluding items such as amortization of intangible assets, restructuring and restructuring-related charges, acquisition and integration costs, and gain or loss on equity investments totaling approximately $73 million, pre-tax. The after-tax impact of these items is estimated to be approximately $59 million, or approximately $1.67 per diluted share.

    Adjusted EPS for 2024 consists of GAAP diluted EPS from continuing operations, excluding the after-tax impact of the Adjusted net income items noted above and the estimated dilution resulting from the potential conversion of our 2028 Convertible Notes expected to be offset by capped call option contracts, which is approximately $0.15 per diluted share.

    Adjusted EBITDA is expected to consist of GAAP income from continuing operations, excluding items such as depreciation, interest, stock-based compensation and taxes totaling approximately $177 million to $181 million.

    (c)Cash flows from operating activities includes an immaterial amount related to discontinued operations.


    Please see “Notes Regarding Non-GAAP Financial Information” for additional information regarding our use of non-GAAP financial measures.

    Supplemental Financial Information

    (dollars in millions)2024
    Outlook    		 2023
    Actual
    Depreciation and amortization$106 to $110 $96
    Adjusted total interest expense(a)$55 to $57 $47
    Stock-based compensation$24 to $25 $23
    Restructuring, acquisition and other charges(b)$20 to $22 $21
    Adjusted effective tax rate(c)18.0% to 19.0% 17.6%
    Leverage ratio(d)2.6x to 2.7x 3.1x
    Capital expenditures(e)$100 to $110 $120
    Cash income tax payments$36 to $40 $30

     

    (a)Adjusted total interest expense refers to our expected full-year GAAP interest expense, expected to range from $55 million to $57 million for 2024, adjusted to remove the full-year impact of charges associated with the accelerated write-off of debt discounts and deferred issuance costs (loss on extinguishment of debt) included in GAAP interest expense, if any. Adjusted total interest expense of $46.8 million for 2023 consists of GAAP interest expense of $51.3 million less $4.5 million of losses from the extinguishment of debt.

    (b)Restructuring, acquisition and other charges consists of restructuring and restructuring-related charges, acquisition and integration costs, other general expenses and incremental costs of complying with the new European Union medical device regulations.

    (c)Adjusted effective tax rate refers to our full-year GAAP effective tax rate, expected to range from 18.0% to 19.0% for 2024, adjusted to reflect the full-year impact of the items that are excluded in providing adjusted net income and certain other identified items. Adjusted effective tax rate of 17.6% for 2023 consists of GAAP effective tax rate of 15.4% adjusted to reflect the impact on the income tax provision related to Non-GAAP adjustments.

    (d)Please see “Notes Regarding Non-GAAP Financial Information” for additional information regarding leverage ratio.

    (e)Capital expenditures is calculated as cash used to acquire property, plant, and equipment (PP&E) less cash proceeds from the sale of PP&E.


    Summary Financial Results

    (dollars in thousands, except per share data)

     Three Months Ended Nine Months Ended
     September 27,
    2024    		 September 29,
    2023    		 QTD Change September 27,
    2024    		 September 29,
    2023    		 YTD Change
    Operating income$58,011 $    48,776 18.9% $151,206 $    119,791 26.2%
    Income from continuing operations$36,282 $28,174 28.8% $88,080 $62,330 41.3%
    Diluted EPS from continuing operations$1.01 $0.83 21.7% $2.49 $1.85 34.6%
                
    EBITDA(a)$86,346 $68,944 25.2% $232,225 $186,839 24.3%
    Adjusted EBITDA(a)$95,526 $80,681 18.4% $265,597 $217,669 22.0%
    Adjusted operating income(a)$75,647 $64,596 17.1% $208,667 $169,158 23.4%
    Adjusted net income(a)$49,832 $43,638 14.2% $133,183 $107,876 23.5%
    Adjusted EPS(a)$1.43 $1.29 10.9% $3.87 $3.20 20.9%

     

    (a)EBITDA, adjusted EBITDA, adjusted operating income, adjusted net income, and adjusted EPS are non-GAAP financial measures. Please see “Notes Regarding Non-GAAP Financial Information” for additional information regarding our use of non-GAAP financial measures. Refer to Tables A, B and C at the end of this release for reconciliations of adjusted amounts to the closest corresponding GAAP financial measures.


    Summary Product Line Results
    (dollars in thousands)

     Three Months Ended
     September 27,
    2024    		 September 29,
    2023    		 QTD Change Organic Change(a)
    Product Line Sales       
    Cardio & Vascular$241,009 $214,004  12.6% 6.2%
    Cardiac Rhythm Management & Neuromodulation 165,094  160,121 3.1% 2.2%
    Advanced Surgical, Orthopedics & Portable Medical 25,314  22,678 11.6% (1.0)%
    Total Sales$431,417 $396,803 8.7% 4.3%
            
     Nine Months Ended
     September 27,
    2024    		 September 29,
    2023    		 YTD Change Organic Change(a)
    Product Line Sales       
    Cardio & Vascular$ 694,278 $   613,701 13.1% 6.5%
    Cardiac Rhythm Management & Neuromodulation 490,086  459,643 6.6% 5.7%
    Advanced Surgical, Orthopedics & Portable Medical 82,735  77,808 6.3% 6.5%
    Total Sales$1,267,099 $1,151,152 10.1% 6.2%

     

    (a)Organic sales change is a non-GAAP financial measure. Please see “Notes Regarding Non-GAAP Financial Information” for additional information regarding our use of non-GAAP financial measures and refer to Table D at the end of this release for a reconciliation of these amounts.


    Conference Call Information

    The Company will host a conference call on Thursday, October 24, 2024, at 8 a.m. CT / 9 a.m. ET to discuss these results. The scheduled conference call will be webcast live and is accessible through our website at investor.integer.net or by dialing (800) 715-9871 (U.S.) or (646) 307-1963 (outside U.S.) and the conference ID is 4525826. The call will be archived on the Company’s website. An earnings call slide presentation containing supplemental information about the Company’s results will be posted to our website at investor.integer.net prior to the conference call and will be referenced during the conference call.

    From time to time, the Company posts information that may be of interest to investors on its website at investor.integer.net. To automatically receive Integer financial news by email, please visit investor.integer.net and subscribe to email alerts.

    About Integer®

    Integer Holdings Corporation (NYSE: ITGR) is one of the largest medical device contract development and manufacturing organizations (CDMO) in the world, serving the cardiac rhythm management, neuromodulation, and cardio and vascular markets. As a strategic partner of choice to medical device companies and OEMs, Integer is committed to enhancing the lives of patients worldwide by providing innovative, high-quality products and solutions. The company's brands include Greatbatch Medical® and Lake Region Medical®. Additional information is available at www.integer.net.

    Investor Relations:

    Andrew Senn
    763.951.8312
    andrew.senn@integer.net

    Notes Regarding Non-GAAP Financial Information

    In addition to our results reported in accordance with generally accepted accounting principles in the United States of America (“GAAP”), we provide adjusted net income, adjusted EPS, earnings before interest, taxes, depreciation and amortization (“EBITDA”), adjusted EBITDA, adjusted operating income, and organic sales change. Unless otherwise indicated, all financial metrics presented reflect continuing operations only.

    Adjusted net income and adjusted EPS consist of GAAP income from continuing operations and diluted EPS from continuing operations, respectively, adjusted for the following to the extent occurring during the period: (i) amortization of intangible assets, (ii) restructuring and restructuring-related charges; (iii) acquisition and integration related costs; (iv) other general expenses; (v) (gain) loss on equity investments; (vi) extinguishment of debt charges; (vii) European Union medical device regulation incremental charges; (viii) inventory step-up amortization; (ix) unusual, or infrequently occurring items; (x) the income tax provision (benefit) related to these adjustments and (xi) certain tax items that are outside the normal tax provision for the period. Adjusted EPS is calculated by dividing adjusted net income by adjusted weighted average shares.

    The weighted average shares used to calculate diluted EPS in accordance with GAAP includes dilution, when applicable, resulting from the potential conversion of our 2.125% Convertible Senior Notes due 2028 (the “2028 Convertible Notes”). In connection with the issuance of the 2028 Convertible Notes, we entered into capped call contracts which are expected to reduce the potential dilution on our common stock in connection with any conversion of the 2028 Convertible Notes, subject to a cap. Adjusted weighted average shares consists of GAAP weighted average shares used to calculate diluted EPS, excluding, when applicable, dilution resulting from the potential conversion of our 2028 Convertible Notes expected to be offset by the capped call contracts.

    EBITDA is calculated by adding back interest expense, provision for income taxes, depreciation expense, and amortization expense from intangible assets and financing leases, to income from continuing operations, which is the most directly comparable GAAP financial measure. Adjusted EBITDA consists of EBITDA plus adding back stock-based compensation and the same adjustments as listed above except for items (i), (vi), (x) and (xi). Adjusted operating income consists of operating income adjusted for the same items listed above except for items (v), (vi), (x) and (xi).

    Organic sales change is reported sales growth adjusted to remove the impact of foreign currency, the contribution of acquisitions and the strategic exit of the Portable Medical market. To calculate the impact of foreign currency on sales growth rates, we convert any sale made in a foreign currency by converting current period sales into prior period sales using the exchange rate in effect at that time and then compare the two, negating any effect foreign currency had on our transactional revenue. For contribution of acquisitions, we exclude the impact on the growth rate attributable to the contribution of acquisitions in all periods where there were no comparable sales. For the strategic exit of the Portable Medical market, we exclude the impact on the growth rate attributable to Portable Medical sales for all periods presented.

    We believe that the presentation of adjusted net income, adjusted EPS, EBITDA, adjusted EBITDA, adjusted operating income, and organic sales change, provides important supplemental information to management and investors seeking to understand the financial and business trends relating to our financial condition and results of operations. In addition to the performance measures identified above, we believe that net total debt and leverage ratio provide meaningful measures of liquidity and a useful basis for assessing our ability to fund our activities, including the financing of acquisitions and debt repayments. Net total debt is calculated as total principal amount of debt outstanding less cash and cash equivalents. We calculate leverage ratio as net total debt divided by adjusted EBITDA for the trailing 4 quarters.

    Forward-Looking Statements

    Some of the statements contained in this press release are “forward-looking statements” within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended, including statements relating to: our 2024 outlook including future sales, expenses, and profitability; the timing for the closing of the Electrochem sale transaction; our ability to execute our business model and our business strategy; projected capital spending; and other events, conditions or developments that will or may occur in the future. You can identify forward-looking statements by terminology such as “outlook,” “projected,” “may,” “will,” “should,” “could,” “expects,” “intends,” “plans,” “anticipates,” “believes,” “estimates,” “predicts,” “potential,” “project,” or “continue” or variations or the negative of these terms or other comparable terminology. These statements are only predictions. Actual events or results may differ materially from those stated or implied by these forward-looking statements. In evaluating these statements and our prospects, you should carefully consider the factors set forth below.

    Although it is not possible to create a comprehensive list of all factors that may cause actual results to differ from the results expressed or implied by our forward-looking statements or that may affect our future results, some of these factors and other risks and uncertainties that arise from time to time are described in Item 1A, “Risk Factors” of our Annual Report on Form 10-K and in our other periodic filings with the SEC and include the following:

    • operational risks, such as our dependence upon a limited number of customers; pricing pressures and contractual pricing restraints we face from customers; our reliance on third-party suppliers for raw materials, key products and subcomponents; interruptions in our manufacturing operations; our ability to attract, train and retain a sufficient number of qualified associates to maintain and grow our business; the potential for harm to our reputation and competitive advantage caused by quality problems related to our products; our dependence upon our information technology systems and our ability to prevent cyber-attacks and other failures; global climate change and the emphasis on Environmental, Social and Governance matters by various stakeholders; our dependence upon our senior management team and key technical personnel; our energy market revenues’ dependence on conditions in the historically volatile oil and natural gas industries; and consolidation in the healthcare industry resulting in greater competition;
    • strategic risks, such as the intense competition we face and our ability to successfully market our products; our ability to respond to changes in technology; our ability to develop new products and expand into new geographic and product markets; and our ability to successfully identify, make and integrate acquisitions to expand and develop our business in accordance with expectations;
    • financial and indebtedness risks, such as our ability to accurately forecast future performance based on operating results that often fluctuate; our significant amount of outstanding indebtedness and our ability to remain in compliance with financial and other covenants under the credit agreement governing our Senior Secured Credit Facilities; economic and credit market uncertainties that could interrupt our access to capital markets, borrowings or financial transactions; the conditional conversion feature of the 2028 Convertible Notes adversely impacting our liquidity, the conversion of our 2028 Convertible Notes, if it were to occur, diluting ownership interests of existing holders of our common stock; the counterparty risk associated with our capped call transaction; the counter financial and market risks related to our international operations and sales; our complex international tax profile; and our ability to realize the full value of our intangible assets;
    • legal and compliance risks, such as regulatory issues resulting from product complaints, recalls or regulatory audits; the potential of becoming subject to product liability or intellectual property claims; our ability to protect our intellectual property and proprietary rights; our ability to comply with customer-driven policies and third-party standards or certification requirements; our ability to obtain and/or retain necessary licenses from third parties for new technologies; our ability and the cost to comply with environmental regulations; legal and regulatory risks from our international operations; the fact that the healthcare industry is highly regulated and subject to various regulatory changes; and our business being indirectly subject to healthcare industry cost containment measures that could result in reduced sales of our products; and
    • other risks and uncertainties that arise from time to time.

    Except as may be required by law, we assume no obligation to update forward-looking statements in this press release whether to reflect changed assumptions, the occurrence of unanticipated events or changes in future operating results, financial conditions or prospects, or otherwise.

    Condensed Consolidated Balance Sheets - Unaudited
    (in thousands)
      
     September 27,
    2024    		 December 31, 2023
    ASSETS   
    Current assets:   
    Cash and cash equivalents$35,574 $23,674
    Accounts receivable, net 241,708  231,283
    Inventories 265,415  229,102
    Refundable income taxes 8,216  1,998
    Contract assets 99,287  85,871
    Prepaid expenses and other current assets 24,956  28,035
    Current assets of discontinued operations held for sale 54,876  17,705
    Total current assets 730,032  617,668
    Property, plant and equipment, net 472,315  392,569
    Goodwill    1,033,078  994,007
    Other intangible assets, net 805,174  779,598
    Deferred income taxes 6,782  7,001
    Operating lease assets 78,624  81,319
    Financing lease assets 17,205  11,675
    Other long-term assets 24,439  22,407
    Noncurrent assets of discontinued operations held for sale —  36,409
    Total assets$3,167,649 $2,942,653
    LIABILITIES AND STOCKHOLDERS’ EQUITY   
    Current liabilities:   
    Current portion of long-term debt$5,000 $—
    Accounts payable 116,837  118,258
    Income taxes payable 571  3,896
    Operating lease liabilities 8,883  8,564
    Accrued expenses and other current liabilities 86,138  86,748
    Current liabilities of discontinued operations held for sale 4,969  3,503
    Total current liabilities 222,398  220,969
    Long-term debt 1,074,339  959,925
    Deferred income taxes 143,236  143,552
    Operating lease liabilities 69,115  72,126
    Financing lease liabilities 13,996  10,272
    Other long-term liabilities 23,379  14,303
    Noncurrent liabilities of discontinued operations held for sale —  2,464
    Total liabilities 1,546,463  1,423,611
    Stockholders’ equity:   
    Common stock 34  33
    Additional paid-in capital 736,125  727,435
    Retained earnings 858,544  771,351
    Accumulated other comprehensive income 26,483  20,223
    Total stockholders’ equity 1,621,186  1,519,042
    Total liabilities and stockholders’ equity$3,167,649 $2,942,653


    Condensed Consolidated Statements of Operations - Unaudited    
    (in thousands, except per share data)       
            
     Three Months Ended Nine Months Ended
     September 27,
    2024    		 September 29,
    2023    		 September 27,
    2024    		 September 29,
    2023
    Sales$431,417  $396,803  $1,267,099  $1,151,152
    Cost of sales 314,849   291,813   924,881   850,827
    Gross profit 116,568   104,990   342,218   300,325
    Operating expenses:       
    Selling, general and administrative 44,820   41,444   137,734   127,875
    Research, development and engineering 11,923   14,068   42,811   48,917
    Restructuring and other charges 1,814   702   10,467   3,742
    Total operating expenses 58,557   56,214   191,012   180,534
    Operating income 58,011   48,776   151,206   119,791
    Interest expense 14,577   11,493   43,140   39,221
    (Gain) loss on equity investments (906)  3,451   (2,035)  3,472
    Other loss, net 916   580   1,796   1,699
    Income from continuing operations before taxes 43,424   33,252   108,305   75,399
    Provision for income taxes 7,142   5,078   20,225   13,069
    Income from continuing operations 36,282   28,174   88,080   62,330
    Income (loss) from discontinued operations, net of tax (843)  (917)  (887)  1,963
    Net income$35,439  $27,257  $87,193  $64,293
            
    Basic earnings per share:       
    Income from continuing operations$1.08  $0.84  $2.62  $1.87
    Income (loss) from discontinued operations$(0.03) $(0.03) $(0.03) $0.06
    Basic earnings per share$1.05  $0.82  $2.60  $1.93
            
    Diluted earnings per share:       
    Income from continuing operations$1.01  $0.83  $2.49  $1.85
    Income (loss) from discontinued operations$(0.02) $(0.03) $(0.03) $0.06
    Diluted earnings per share$0.99  $0.81  $2.46  $1.91
            
    Weighted average shares outstanding:       
    Basic 33,656   33,346   33,579   33,305
    Diluted 35,791   33,774   35,441   33,679


    Condensed Consolidated Statements of Cash Flows - Unaudited (a)
    (in thousands)
      
     Nine Months Ended
     September 27,
    2024    		 September 29,
    2023
    Cash flows from operating activities:   
    Net income$87,193  $ 64,293 
    Adjustments to reconcile net income to net cash provided by operating activities:   
    Depreciation and amortization 82,104   73,116 
    Debt related charges included in interest expense 2,962   7,126 
    Inventory step-up amortization 1,056   — 
    Stock-based compensation 18,729   17,099 
    Non-cash lease expense 6,928   8,124 
    Non-cash (gain) loss on equity investments (2,035)  3,472 
    Contingent consideration fair value adjustment —   (526)
    Other non-cash (gains) losses 4,433   (734)
    Deferred income taxes —   (5)
    Changes in operating assets and liabilities, net of acquisition:   
    Accounts receivable (4,888)  (58)
    Inventories (31,515)  (25,785)
    Prepaid expenses and other assets (495)  (1,473)
    Contract assets (13,159)  (14,863)
    Accounts payable 4,295   (869)
    Accrued expenses and other liabilities (5,355)  7,401 
    Income taxes payable (8,279)  (11,692)
    Net cash provided by operating activities 141,974   124,626 
    Cash flows from investing activities:   
    Acquisition of property, plant and equipment (86,267)  (82,885)
    Purchase of intangible asset (250)  — 
    Proceeds from sale of property, plant and equipment 30   100 
    Acquisitions, net (138,544)  — 
    Net cash used in investing activities (225,031)  (82,785)
    Cash flows from financing activities:   
    Principal payments of long-term debt (2)  (415,938)
    Proceeds from issuance of convertible notes, net of discount —   486,250 
    Proceeds from revolving credit facility 234,500   294,603 
    Payments of revolving credit facility (117,500)  (353,993)
    Purchase of capped calls —   (35,000)
    Payment of debt issuance costs (2,071)  (2,181)
    Proceeds from the exercise of stock options 742   2,303 
    Tax withholdings related to net share settlements of restricted stock unit awards (10,773)  (3,067)
    Contingent consideration payments —   (7,660)
    Principal payments on finance leases (9,772)  (854)
    Other financing activities 501   — 
    Net cash provided by (used in) financing activities 95,625   (35,537)
    Effect of foreign currency exchange rates on cash and cash equivalents (668)  1,566 
    Net increase in cash and cash equivalents 11,900   7,870 
    Cash and cash equivalents, beginning of period 23,674   24,272 
    Cash and cash equivalents, end of period$35,574  $32,142 


    (a)The Condensed Consolidated Statements of Cash Flows - Unaudited includes cash flows related to discontinued operations.


    Table A: Adjusted Net Income and Diluted EPS from Continuing Operations Reconciliations
    (in thousands, except per share amounts)

     Three Months Ended
     September 27, 2024 September 29, 2023
     Pre-Tax Net of Tax Per
    Diluted
    Share(a)    		 Pre-Tax Net of Tax Per
    Diluted
    Share(a)
    Income from continuing operations (GAAP)$43,424  $36,282  $1.01  $33,252 $28,174 $0.83
    Adjustments(b):           
    Amortization of intangible assets 13,626   10,972   0.32   13,021  10,292  0.30
    Certain legal expenses (SG&A)(c) 481   381   0.01   —  —  —
    Restructuring and restructuring-related charges(d) 1,916   1,467   0.04   470  444  0.01
    Acquisition and integration costs(e) 1,017   800   0.02   777  580  0.02
    Other general expenses(f) 83   76   —   28  28  —
    (Gain) loss on equity investments(g) (906)  (716)  (0.02)  3,451  2,726  0.08
    Loss on extinguishment of debt(h) —   —   —   87  68  —
    Medical device regulations(i) 209   165   —   205  164  —
    Other adjustments(j) 304   240   0.01   1,319  1,042  0.03
    Tax adjustments(k) —   165   —   —  120  —
    Impact of capped call option contracts —   —   0.03   —  —  —
    Adjusted net income (non-GAAP)$60,154  $49,832  $1.43  $52,610 $43,638 $1.29
                
    Weighted average shares for diluted EPS (GAAP)   35,791       33,774  
    Less: 2028 Convertible Notes capped call options impact   (1,003)      —  
    Adjusted weighted average shares (non-GAAP)   34,788       33,774  
                
     Nine Months Ended
     September 27, 2024 September 29, 2023
     Pre-Tax Net of Tax Per
    Diluted
    Share(a)    		 Pre-Tax Net of Tax Per
    Diluted
    Share(a)
    Income from continuing operations (GAAP)$108,305  $88,080  $2.49  $75,399 $62,330 $1.85
    Adjustments(b):           
    Amortization of intangible assets 40,586   32,668   0.95   38,884  30,735  0.91
    Certain legal expenses (SG&A)(c) 835   660   0.02   —  —  —
    Restructuring and restructuring-related charges(d) 5,738   4,569   0.13   5,162  4,120  0.12
    Acquisition and integration costs(e) 8,408   6,658   0.19   1,715  1,282  0.04
    Other general expenses(f) (972)  (653)  (0.02)  137  107  —
    (Gain) loss on equity investments(g) (2,035)  (1,608)  (0.05)  3,472  2,743  0.08
    Loss on extinguishment of debt(h) —   —   —   4,518  3,569  0.11
    Medical device regulations(i) 762   602   0.02   1,241  981  0.03
    Other adjustments(j) 1,048   828   0.02   2,228  1,760  0.05
    Inventory step-up amortization (COS)(l) 1,056   834   0.02   —  —  —
    Tax adjustments(k) —   545   0.02   —  249  0.01
    Impact of capped call option contracts —   —   0.07   —  —  —
    Adjusted net income (Non-GAAP)$163,731  $133,183  $3.87  $132,756 $107,876 $3.20
                
    Weighted average shares for diluted EPS (GAAP)    35,441          33,679  
    Less: 2028 Convertible Notes capped call options impact   (1,027)      —  
    Adjusted weighted average shares (non-GAAP)   34,414       33,679  


     

    (a)Income from continuing operations (GAAP) per diluted share amounts are calculated in accordance with GAAP using weighted average shares for diluted EPS. The per share amounts for the adjustments in the table above and adjusted net income are calculated using adjusted weighted average shares.
     
    (b)The difference between pre-tax and net of tax amounts is the estimated tax impact related to the respective adjustment. Net of tax amounts are computed using a 21% U.S. tax rate, and the statutory tax rates applicable in foreign tax jurisdictions, as adjusted for the existence of net operating losses (“NOLs”). Expenses that are not deductible for tax purposes (i.e. permanent tax differences) are added back at 100%.
     
    (c)Certain legal expenses associated with non-ordinary course legal matters.
     
    (d)We initiate discrete restructuring programs primarily to realign resources to better serve our customers and markets, improve operational efficiency and capabilities, and lower operating costs or improve profitability. Depending on the program, restructuring charges may include termination benefits, contract termination, facility closure and other exit and disposal costs. Restructuring-related expenses are directly related to the program and may include retention bonuses, accelerated depreciation, consulting expense and costs to transfer manufacturing operations among our facilities.

    (e)Acquisition and integration costs are incremental costs that are directly related to a business or asset acquisition. These costs may include, among other things, professional, consulting and other fees, system integration costs, and fair value adjustments relating to contingent consideration.

    (f)Other general expenses are discrete transactions occurring sporadically and affect period-over-period comparisons. The expenses for the 2024 and 2023 periods include gains and losses in connection with the disposal of property, plant and equipment. In addition, during the second quarter of 2024, we recorded $1.2 million of loss recoveries relating to property damage which occurred in the fourth quarter of 2023 at one of our manufacturing facilities.

    (g)Amounts reflect our share of equity method investee (gains) losses including unrealized appreciation/depreciation of the underlying interests of the investee.

    (h)Loss on extinguishment of debt consists of accelerated write-offs of unamortized deferred debt issuance costs and discounts, which are included in interest expense. The 2023 amount represents a write-off of unamortized deferred debt issuance costs and discounts in connection with the amendments to the credit agreement governing our credit facilities, prepayments of portions of the Term Loan A Facility, and repayment in full of the Term Loan B Facility.

    (i)The charges represent incremental costs of complying with the new European Union medical device regulations for previously registered products and primarily include charges for contractors supporting the project and other direct third-party expenses.

    (j)Amount primarily relates to costs associated with certain formal strategic projects. Strategic projects primarily involve system reconfiguration to support our manufacturing excellence operational strategic imperative and investments in certain technology and platform development to align our capabilities to meet customer needs.

    (k)Tax adjustments predominately relate to acquired foreign tax credits, including utilization, changes to uncertain tax benefits and associated interest.

    (l)The accounting associated with our acquisitions require us to record inventory at its fair value, which is sometimes greater than the previous book value of inventory. The increase in inventory value is amortized to cost of sales over the period that the related inventory is sold. We exclude inventory step-up amortization from our non-GAAP financial measures because it is a non-cash expense that we do not believe is indicative of our ongoing operating results.


    Please see “Notes Regarding Non-GAAP Financial Information” for additional information regarding our use of non-GAAP financial measures.

    Table B: Adjusted Operating Income Reconciliations
    (in thousands)

     Three Months Ended Nine Months Ended
     September 27,
    2024    		 September 29,
    2023    		 September 27,
    2024    		 September 29,
    2023
    Operating income (GAAP)$58,011 $48,776 $151,206  $119,791
    Adjustments:       
    Amortization of intangible assets 13,626  13,021  40,586   38,884
    Certain legal expenses 481  —  835   —
    Restructuring and restructuring-related charges 1,916  470  5,738   5,162
    Acquisition and integration costs 1,017  777  8,408   1,715
    Other general expenses 83  28  (972)  137
    Medical device regulations 209  205  762   1,241
    Other adjustments 304  1,319  1,048   2,228
    Inventory step-up amortization —  —  1,056   —
    Adjusted operating income (non-GAAP)$75,647 $64,596 $208,667  $169,158


    Table C: EBITDA Reconciliations
    (in thousands)

     Three Months Ended Nine Months Ended
     September 27,
    2024    		 September 29,
    2023    		 September 27,
    2024    		 September 29,
    2023
    Income from continuing operations (GAAP)$36,282  $28,174 $88,080  $62,330
            
    Interest expense 14,577     11,493  43,140   39,221
    Provision for income taxes 7,142   5,078  20,225   13,069
    Depreciation(a) 14,025   10,836  38,424   32,337
    Amortization of intangible assets and financing leases 14,320   13,363  42,356   39,882
    EBITDA (non-GAAP) 86,346   68,944  232,225   186,839
    Stock-based compensation(a) 6,076   5,487  18,532   16,875
    Certain legal expenses 481   —  835   —
    Restructuring and restructuring-related charges 1,916   470  5,738   5,162
    Acquisition and integration costs 1,017   777  8,408   1,715
    Other general expenses 83   28  (972)  137
    (Gain) loss on equity investments (906)  3,451  (2,035)  3,472
    Medical device regulations 209   205  762   1,241
    Other adjustments 304   1,319  1,048   2,228
    Inventory step-up amortization —   —  1,056   —
    Adjusted EBITDA (non-GAAP)$95,526  $80,681 $265,597  $217,669


    (a)Excludes amounts included in Restructuring and restructuring-related charges.


    Table D: Organic Sales Change Reconciliation (% Change)

     GAAP Reported Growth Impact of Foreign Currency(a) Impact of Strategic Exits and Acquisitions(a) Non-GAAP Organic Change
    QTD Change (3Q 2024 vs. 3Q 2023)       
    Product Line       
    Cardio & Vascular12.6% 0.1% 6.3% 6.2%
    Cardiac Rhythm Management & Neuromodulation3.1% —% 0.9% 2.2%
    Advanced Surgical, Orthopedics & Portable Medical11.6% —% 12.6% (1.0)%
    Total Sales8.7% 0.1% 4.3% 4.3%
            
    YTD Change (9M 2024 vs. 9M 2023)       
    Product Line       
    Cardio & Vascular13.1% 0.1% 6.6% 6.5%
    Cardiac Rhythm Management & Neuromodulation6.6% —% 0.9% 5.7%
    Advanced Surgical, Orthopedics & Portable Medical6.3% —% (0.2)% 6.5%
    Total Sales10.1% —% 3.9% 6.2%

     

    (a) Sales growth has been adjusted to exclude the impact of foreign currency exchange rate fluctuations and acquisitions and strategic exits.


    Table E: Net Total Debt Reconciliation
    (in thousands)

     September 27,
    2024    		 December 31,
    2023
    Total debt$1,079,339 $959,925
    Add: Debt discounts and deferred issuance costs included in Total debt 11,659  14,075
    Total principal amount of debt outstanding 1,090,998  974,000
    LESS: Cash and cash equivalents 35,574  23,674
    Net Total Debt (Non-GAAP)$1,055,424 $950,326

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